What's Hot in 2019: Advances in Fighting Antibiotic Resistance

Phage therapy and naturally-occurring antibiotics represent up-and-coming strategies in the fight against superbugs

The development of phage therapies to combat drug-resistant infections

With multi-drug resistant infections escalating, phage therapy might help us get back in the fight and beat the superbugs at their own game.The arrival of antibiotics in the in the 1950s heralded what many thought would be the death of dangerous infections. Unfortunately, antibiotic resistance genes, now abundant in the environment and encouraged by the overuse and misuse of antibiotics, have diminished the effectiveness of these infection fighters. In the age of multi-drug resistance, could phage therapy be the effective alternative to antibiotics we have been searching for? Phage therapy relies on the use of naturally-occurring phages to infect and lyse bacteria at the site of infection. Although there are several clinical trials ongoing, there is only one FDA-approved phage therapy product on the market that is being used to kill a virulent food-borne pathogen. But with tools like CRISPR-Cas9 we now have a way of understanding phages and their bacterial hosts, which could open the door to using phages for selective diseases. Let’s beat the superbugs at their own game!

With the failure of conventional antibiotic treatment becoming a global crisis, research is looking increasingly to novel approaches, for example bacteriophage therapy or combining existing antibiotics with drugs that inactivate resistance mechanisms. Earlier this year a new class of antibiotic was announced—odilorhabdins (ODLs) are produced by symbiotic bacteria found in nematode worms and target the bacterial ribosome. These have been shown to be effective against carbapenem-resistant Enterobacteriacae. Another up and coming area is host directed therapy, which involves modulating various host factors, such as boosting the immune system or targeting pathways that may contribute to immunopathology. This area is showing particular promise in the treatment of drug resistant TB (the world’s leading infectious killer). Research in this field looks set to continue expanding.